Provider Demographics
NPI:1497916050
Name:CATHOLIC SENIOR LIVING
Entity Type:Organization
Organization Name:CATHOLIC SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-776-0971
Mailing Address - Street 1:1621 COLLINS AVE
Mailing Address - Street 2:SUITE 903
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3123
Mailing Address - Country:US
Mailing Address - Phone:305-776-0971
Mailing Address - Fax:786-427-1380
Practice Address - Street 1:100 SW 52ND AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1291
Practice Address - Country:US
Practice Address - Phone:786-552-5704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL101143104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness